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April 2012 · Vol. 24, No. 4

Editorial

Stop performing
median episiotomy!

Start using a mediolateral incision when episiotomy is indicated

Robert  L.  Barbieri,  MD

Editor in Chief
ROBERT.BARBIERI@QHC.COM

Advocates of the liberal use of episiotomy have hypothesized that the procedure has many benefits, including:

  • expediting delivery when warranted in the second stage

  • protecting the maternal perineum from lacerations

  • reducing pelvic relaxation and incontinence

  • protecting the fetal head

  • facilitating the performance of operative delivery

  • reducing the risk of shoulder dystocia.

Most studies do not provide strong support for these claims.
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